Hyun Bin Park; Yoon Hee Kim; Ji Young Baek; Kyung Won Kim; Myung Hyun Sohn; Kyu-Earn Kim

doi:10.7581/pard.2012.22.2.171

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Park, Kim, Baek, Kim, Sohn, and Kim: Usefulness of ΔFEV0.75 and ΔFEV0.5 for Airway Reversibility in Preschoolers with Asthma

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(2): 171-179.

Published online: 30 June 2012

DOI: https://doi.org/10.7581/pard.2012.22.2.171

Usefulness of ΔFEV_0.75 and ΔFEV_0.5 for Airway Reversibility in Preschoolers with Asthma

Hyun Bin Park, MD, Yoon Hee Kim, MD, Ji Young Baek, MD, Kyung Won Kim, MD, PhD, Myung Hyun Sohn, MD, PhD, Kyu-Earn Kim, MD, PhD

Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author (mhsohn@yuns.ac)

Received 14 February 2012 Revised 1 March 2012 Accepted 26 March 2012

Abstract

Purpose

Preschoolers complete forced expiration in a short time, sometimes more quickly than in 1 second, and therefore the importance of forced expiatory volume in 0.75 seconds (FEV_0.75) or forced expiatory volume in 0.5 seconds (FEV_0.5) has been raised. The purpose of this study is to evaluate the clinical usefulness of ΔFEV_0.75 and ΔFEV_0.5.

Methods

We analyzed 401 subjects of an asthma group, and 150 subjects of a control group under 7 years of age.

Results

ΔFEV₁, ΔFEV_0.75 and ΔFEV_0.5 values of the asthma group were significantly higher than those of the control group, respectively (P<0.0001). ΔFEV₁ (0.60; 95% confidence interval [CI], 0.57 to 0.62), ΔFEV_0.75 (0.61; 0.58 to 0.65), and ΔFEV_0.5 (0.60; 0.56 to 0.64) showed no significant difference in the diagnostic ability of asthma when airway reversibility is defined as ΔFEVt≥12%. Cutoff values for asthma were 8.6% in ΔFEV₁, 7.9% in ΔFEV_0.75 and 14.2% in ΔFEV_0.5. ΔFEV_0.75 (0.91; 0.88 to 0.94) showed significantly higher area under curve (AUC) than ΔFEV_0.5 (0.77; 0.73 to 0.82) when stratified by 12%, in predicting airway reversibility defined as ΔFEV₁≥12%. Cutoff values were 12.3% in ΔFEV_0.75, and 13.4% in ΔFEV_0.5. When airway reversibility is defined as ΔFEV₁≥8.6%, ΔFEV_0.75 (0.90; 0.87 to 0.92) also showed significantly higher AUC than ΔFEV_0.5 (0.79; 0.75 to 0.82), and Cutoff values were 8.4% in ΔFEV_0.75, and 11.3% in ΔFEV_0.5.

Conclusion

ΔFEV_0.75 or ΔFEV_0.5 can be a means to replace ΔFEV₁ for diagnosis of asthma and assessment of airway reversibility in preschool children.

Keywords: Spirometry, Preschool children, Asthma, Forced expiratory volume

Figures and Tables

Fig. 1

Receiver operating characteristic (ROC) curves of ΔFEV₁, ΔFEV_0.75 and ΔFEV_0.5 for diagnosis of asthma when bronchodilator response is defined as ΔFEVt≥12%. ΔFEV₁ (0.60; 95% confidence interval, 0.57-0.62), ΔFEV_0.75 (0.61, 0.58-0.65), and ΔFEV_0.5 (0.60, 0.56-0.64) showed no significant difference in area under curve of ROC curves. FEV₁, forced expiratory volume in 1 second; FEV_0.75, forced expiratory volume in 0.75 second; FEV_0.5, forced expiratory volume in 0.5 second.

Fig. 2

Receiver operating characteristic (ROC) curves ΔFEV_0.75 and ΔFEV_0.5 when stratified by 12% for airway reversibility defined as ΔFEV₁≥12%. ΔFEV_0.75 (0.91, 0.88-0.94) showed significantly higher area under curve than ΔFEV_0.5 (0.77, 0.73-0.82). FEV_0.75, forced expiratory volume in 0.75 second; FEV_0.5, forced expiratory volume in 0.5 second.

Fig. 3

Receiver operating characteristic (ROC) curves ΔFEV_0.75 and ΔFEV_0.5 when stratified by 8.6% for airway reversibility defined as ΔFEV₁≥8.6%. ΔFEV_0.75 (0.90, 0.87-0.92) showed significantly higher area under curve than ΔFEV_0.5 (0.79, 0.75-0.82). FEV_0.75, forced expiratory volume in 0.75 second; FEV_0.5, forced expiratory volume in 0.5 second.

Table 1

Baseline Characteristics and Sprimetric Parameters of Asthma and Control groups

Values are presented as median (interquartile range).

FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; FEF_25-75, forced expiratory flow between 25% and 75%; FEV_0.75, forced expiratory volumein 0.75 second; FEV_0.5, forced expiratory volume in 0.5 second.

^*P-values comparing asthma and control groups were calculated by using the chi-square test (for categorical variables) or Mann-Whitney test (for continuous variables).

Table 2

Performances of ΔFEV₁, ΔFEV_0.75 and ΔFEV_0.5 in Diagnosing Asthma

FEV1, forced expiratory volume in 1 second; FEV_0.75, forced expiratory volume in 0.75 second; FEV_0.5, forced expiratory volume in 0.5 second; AUC, area under curve; CI, confidence interval.

Table 3

Performances of ΔFEV_0.75 and ΔFEV_0.5 in Predicting Airway Reversibility Defined as ΔFEV₁≥12%

FEV_0.75, forced expiratory volume in 0.75 second; FEV_0.5, forced expiratory volume in 0.5 second; FEV₁, forced expiratory volume in 1 second; AUC, area under curve; CI, confidence interval.

Table 4

Performances of ΔFEV_0.75 and ΔFEV_0.5 in Predicting Airway Reversibility Defined as ΔFEV₁≥8.6%

FEV_0.75, forced expiratory volume in 0.75 second; FEV_0.5, forced expiratory volume in 0.5 second; FEV₁, forced expiratory volume in 1 second; AUC, area under curve; CI, confidence interval.

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